Psychosocial therapy for posttraumatic stress disorder.

Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, PA 19104, USA.
The Journal of Clinical Psychiatry (Impact Factor: 5.14). 02/2006; 67 Suppl 2:40-5.
Source: PubMed

ABSTRACT Immediately after experiencing a traumatic event, many people have symptoms of posttraumatic stress disorder (PTSD). If trauma victims restrict their routine and systematically avoid reminders of the incident, symptoms of PTSD are more likely to become chronic. Several clinical studies have shown that programs of cognitive-behavioral therapy (CBT) can be effective in the management of patients with PTSD. Prolonged exposure (PE) therapy-a specific form of exposure therapy-can provide benefits, as can stress inoculation training (SIT) and cognitive therapy (CT). PE is not enhanced by the addition of SIT or CT. PE therapy is a safe treatment that is accepted by patients, and benefits remain apparent after treatment programs have finished. Nonspecialists can be taught to practice effective CBT. For the treatment of large numbers of patients, or for use in centers where CBT has not been routinely employed previously, appropriate training of mental health professionals should be performed. Methods used for the dissemination of CBT to nonspecialists need to be modified to meet the requirements of countries affected by the Asian tsunami. This will entail the use of culturally sensitive materials and the adaptation of training methods to enable large numbers of mental health professionals to be trained together.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: Technological disasters result from human error, negligence, or limitations in perceiving and reducing risk. They are a form of manmade disaster that exerts a devastating effect on impacted individuals, communities, and ecosystems. Because of their negative impacts, technological disasters often erode community connectedness, undermine adaptive coping strategies in victims, contribute to income and social capital loss, result in complicated legal proceedings that can forestall the provision of needed post-disaster resources, and make it difficult for victims to find meaning in their struggles and recover from disaster. However, 5 empirically supported intervention principles may help mitigate some of these negative effects. These include promoting a sense of safety among victims, calming and supporting fearful individuals, engendering a general sense of self-efficacy and collective efficacy, increasing feelings of connectedness, and inspiring hope in discouraged disaster victims. This article discusses the application of these principles, as well as specific ways that they can be applied to support the needs of children, families, schools, and communities impacted by technological disasters.
    01/2013; 1(1):3-12. DOI:10.1080/21683603.2013.780192
  • [Show abstract] [Hide abstract]
    ABSTRACT: Given that odors enhance the retrieval of autobiographical memories, induce physiological arousal, and trigger trauma-related flashbacks, it is reasonable to hypothesize that odors play a significant role in the pathophysiology of posttraumatic stress disorder (PTSD). For these reasons, this preliminary study sought to examine self-reported, odor-elicited distress in PTSD. Combat veterans with (N=30) and without (N=22) PTSD and healthy controls (HC: N=21), completed an olfactory questionnaire that provided information on the hedonic valence of odors as well as their ability to elicit distress or relaxation. Two main findings were revealed: Compared to HC, CV+PTSD, but not CV-PTSD, reported a higher prevalence of distress to a limited number of select odors that included fuel (p=.004), blood (p=.02), gunpowder (p=.03), and burning hair (p=.02). In contrast to this increased sensitivity, a blunting effect was reported by both groups of veterans compared to HC that revealed lower rates of distress and relaxation in response to negative hedonic odors (p=.03) and positive hedonic odors (p<.001), respectively. The study is limited by its use of retrospective survey methods, whereas future investigations would benefit from laboratory measures taken prior, during, and after deployment. The present findings suggest a complex role of olfaction in the biological functions of threat detection. Several theoretical models are discussed. One possible explanation for increased sensitivity to select odors with decreased sensitivity to other odors is the co-occurrence of attentional bias toward threat odors with selective ignoring of distractor odors. Working together, these processes may optimize survival. Copyright © 2015 Elsevier B.V. All rights reserved.
    Journal of Affective Disorders 03/2015; 179:23-30. DOI:10.1016/j.jad.2015.03.026 · 3.71 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: There have been few direct examinations of the volitional control of emotional responses to provocative stimuli in PTSD. To address this gap, an emotion regulation task was administered to 27 Operation Enduring Freedom/Operation Iraqi Freedom combat veterans and 23 healthy controls. Neutral and aversive photographs were presented to participants who did or did not employ emotion regulation strategies. Objective indices included corrugator electromyogram, the late positive potential, and the electrocardiogram. On uninstructed trials, participants with PTSD exhibited blunted cardiac reactivity rather than the exaggerated cardioacceleratory responses seen in trauma cue reactivity studies. On interleaved regulation trials, no measure evidenced group differences in voluntary emotion regulation. Persons with PTSD may not differ from normals in their capacity to voluntarily regulate normative emotional responses to provocative stimuli in the laboratory, though they may nevertheless respond differentially on uninstructed trials and endorse symptoms of dyscontrol pathognomonic of the disorder outside of the laboratory. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
    Psychophysiology 12/2014; DOI:10.1111/psyp.12392 · 3.18 Impact Factor